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what is it?
Practitioners of herbal medicine use all or parts of plants to treat a wide range of complaints. Animals instinctively know which herbs to eat if wounded or bitten, and our earliest use of herbal remedies was probably intuitive. Ancient Chinese and Egyptian records over 2,000 years old refer to herbal medicine, and until science developed pharmaceutical drugs, herbs were part of standard medical practice. They are still an important element in folk medicine around the world.
The therapeutic properties of plants are widely accepted, and scientists have drawn on herbal lore to develop modern pharmaceuticals. Digoxin, for instance, a drug used to treat heart failure, is a synthesised form of digitalis, an active chemical in the foxglove plant, which is a traditional remedy for heart conditions.
Rather than treating symptoms in isolation, Western herbal medicine seeks to restore what it calls the 'vital force', the body's natural capacity to protect, regulate, renew and heal itself. A herbalist will not simply hand you a cream for a rash, but try to find the source of the problem. Is it caused by stress or poor diet? Or by a poorly performing liver? A remedy for eczema may include herbs to help you relax as well as ones to soothe the skin.
Medical herbalists prepare remedies tailored to individual patients. They prefer to use the natural plant as a medicine, but scientific analysis has enabled researchers to identify the actual chemical components of plants. Standardisation techniques that ensure an optimum level of the active ingredient in every dose plus mass production methods mean that herbal preparations are available in health shops and pharmacists as commercially packaged tablets, capsules, tinctures, oils, creams, ointments and teas. This enables people to treat themselves for minor complaints like mild depression (St John's wort), colds (echinacea and goldenseal) and migraine (feverfew). As a result herbal products are a market totalling about £240 million a year.
what it's supposed to do
Herbalists believe that the chemical components of plants act in synergy, creating a greater therapeutic power together than if on their own. This mix also tends to counteract the possible side effects of an individual ingredient. For example, salicylic acid, the active component in aspirin, can irritate the stomach lining. In meadowsweet, the herbal remedy for fevers, rheumatic conditions and infections, its side effects are offset by tannin and mucilage, natural protectors and healers.
Where there are several active ingredients, a herb may be used for different purposes. St John's wort, for instance, enhances mood and is also anti-inflammatory and anti-viral.
There are remedies for almost every condition, but herbal medicine is most commonly used for chronic or recurring conditions like migraine and arthritis, respiratory, circulatory and digestive disorders, skin conditions, mild depression, insomnia, cystitis, PMS and menopausal problems.
what happens
The first appointment with a medical herbalist usually lasts an hour. You will be asked about your personal and family medical history (including details of conventional medication to ensure remedies are compatible), your lifestyle habits (particularly areas that may cause stress), work, relationships, emotional state and recent life events. The herbalist may carry out simple medical tests like taking your pulse.
Depending on the conclusions, the herbalist will prescribe one or more remedies to suit your individual problem and constitution. These are usually made up straightaway in the on-site dispensary in the form of decoctions, tinctures, infusions, creams or ointments as appropriate. The herbalist will expect to see you in a week or two to check progress.
If treating yourself with over-the-counter remedies, follow instructions and choose products from well-established manufacturers. Remember that herbal remedies often take longer to work than conventional medicines.
what's the evidence?
Major pharmaceutical companies have shown little interest in funding research to date as most herbal remedies cannot be patented. But a growing number of studies in prestigious medical journals now support the efficacy of certain herbs for specific conditions.
St John's wort has been shown to relieve mild to moderate depression as effectively as tricyclic antidepressants (British Medical Journal 1996, 1999, 2000). Saw palmetto was found to reduce the symptoms of benign prostatic hypertrophy (prostate problems) (Journal of the American Medical Association 1998). Ginkgo biloba can improve circulation in peripheral blood vessels and delay memory impairment in the elderly. Ginger was found to relieve nausea in post-operative patients (British Journal of Anaesthesia 2000). Garlic seems to lower blood cholesterol and fat levels and reduce high blood pressure. Agnus castus eases PMS; and black cohosh reduces hot flushes. A standardised extract of the herb butterbur relieved hayfever, according to a Swiss study in the British Medical Journal in 2002.
precautions
Go to the safety first section of 'before you start' for some general precautions to take into account when considering a complementary therapy.
- Tell your herbalist what drugs and supplements you are taking and if you are pregnant, have heart disease, high blood pressure or glaucoma.
- Tell your doctor if you are taking herbal remedies.
- Herbal remedies can have side effects or may interfere with conventional medication, so always consult a qualified medical herbalist or ask the pharmacist. For example, St John's wort could interfere with certain prescription medicines, including drugs used to treat transplant patients (cyclosporin), heart conditions and blood clots (warfarin, digoxin), asthma (theophylline), depression (SSRIs), migraine (triptans), HIV infection and the oral contraceptive pill. As a result, all products on sale in the UK carry a label advising would-be users to seek advice from their pharmacist or doctor if taking prescription medicine. Kava kava has also been linked with liver damage.
- Do not discontinue or change the dosage of a prescribed medication without consulting your doctor.
how to find a practitioner
Herbal medicine is one of the five top-rated therapies in the recent House of Lords' Select Committee on Complementary and Alternative Medicine. The European Herbal Practitioners Association, which represents the majority of UK herbalists, is taking steps to make herbal medicine a legally regulated profession like dentistry. It will have a list of registered practitioners, a code of practice and ethics, educational standards and approved training colleges and complaints and disciplinary procedures.
Herbalists are keen to be regulated so that they can continue prescribing herbs that may be affected if herbal medicinal products are restricted. This is likely if licensing procedures are harmonised across the European Union. The Department of Health and the Committee on Safety of Medicines are also unhappy at the number of unlicensed and unregulated herbal remedies available, a situation highlighted when the toxic plant Aristolochia (snakeroot) was found in Chinese formulas.
It is advisable to find a practitioner registered with an organisation that is a member of the European Herbal Practitioners Association.
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(July 2002)
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